Adherence to the WHO physical activity, screen time and sleep guidelines and associations with socio-demographic factors among Ethiopian preschool children: The SUNRISE study.

Background: The World Health Organisation (WHO) has called for more evidence on 24-hour movement behaviours from low- and middle-income countries. We examined the proportion of Ethiopian children aged 3.0-4.9 years who met the WHO guidelines on physical activity, screen time and sleep for children under the age of five, and the associations between meeting the guidelines and socio-demographic factors.

Methods: A cross-sectional study was conducted in Adama and Lume district, Ethiopia. Children were recruited through kindergartens in Adama city and rural villages of Lume district, Ethiopia. Physical activity and sleep were measured using ActiGraph accelerometer. Screen time and restrained sitting were parent-reported. Multivariable logistic regression models tested associations between meeting the individual and combined WHO guidelines and socio-demographic factors.

Results: A total of 430 children participated in the study (mean age 4.2 ± 0.6 years). More than half the children (58.0%) met all the WHO guidelines. A higher proportion met the physical activity (96.1%) and sleep guidelines (91.9%) compared to the screen time guideline (63.5%). Children who lived in rural areas were more likely to meet the screen time (84.6% vs. 38.2%, AOR = 7.31; 95%CI: 3.93, 14.02), sleep (98.6% vs. 83.8%, AOR = 8.60; 95%CI: 3.55, 23.73) and combined (81.3% vs. 30.1%, AOR = 7.41; 95%CI: 4.04, 13.97) guidelines than those who lived in urban areas.

Conclusions: Children from rural Ethiopia were more compliant with the WHO guidelines than their urban counterparts. Strategies to reduce screen time and promote healthy movement behaviours in urban areas are needed. Further studies with a larger representative sample might provide better insight across the regions within the country.